Original Research Article
Year: 2020 | Month: December | Volume: 7 | Issue: 12 | Pages: 582-589
Prevalence of Spontaneous Ascitic Fluid Infection and its Microbiological Profile in Decompensated Cirrhotic Liver Disease Patients in a Tertiary Health Care Hospital in Puducherry
M. K. Uthaya Sankar1, Swapna U. S2, Mythreini3, R. Gopal4
1Professor of Medicine, 2,3PG Resident, 4Professor of Microbiology, Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry-605107, India
Corresponding Author: Swapna U S
ABSTRACT
Background: Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a study to determine bacterial etiology, susceptibility patterns.
Objective: To estimate the prevalence of spontaneous ascitic fluid infection in cirrhotic decompensated liver disease patients, and to analyse microbiological profile in cirrhotic ascites.
Method: We prospectively collected clinical data and laboratory values. Diagnostic paracentesis was performed in all patients of decompensated cirrhotic liver disease with ascites to investigate the presence of SAI.
Result: Among total 45 patients the leading cause of cirrhosis was alcohol consumption. SAI was diagnosed in 27 patients (60%). Of these, 19 patients (70 %) had culture negative neutrocytic ascites (CNNA), 5 (18.5%) had Spontaneous bacterial peritonitis (SBP), and 3 (11.1%) had mono microbial non neutrocytic bacterascites (MNB). CNNA and SBP did not differ in terms of clinical characteristics. Organisms found are - two Streptococci and two coagulase negative staphylococci, two E. coli, one klebsiella pneumonia, one candida growth. Gram positive cocci (50%) were predominant among culture positive SAI, gram negative bacilli (37.5%), fungus (12.5%). Among the commonly used antibiotics higher resistance rate was found with cephalosporins (71.4%) and most sensitive antibiotics found to be carbapenems, linezolid, vancomycin (85%), then amino glycosides and tetracycline (71%).
Keywords: SAI, Ascitic fluid culture, Antibiotic sensitivity.
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